Why do I have headaches and neck pain after a car wreck, or "whiplash Injury?"

Motor vehicle collisions (MVC) have been research for years, and the mechanisms causing damage to the tissues of the spine are well understood.  Many people can suffer with chronic pain for a lifetime after a whiplash injury, but why is that?  Patients routinely tell me that "my x-rays and MRI are negative but I still hurt."  Well, there is a reason for persistent pain after a MVC, and it is the spinal ligaments.  During a whiplash injury the most commonly injured tissues are the facet joint ligaments and spinal discs.  When damaged ligaments of the spine are permanently changed, and in many cases torn which causes them to lengthen, resulting in ligament laxity and joint looseness.  Joint looseness is considered a very big problem when it is excessive.  If your vertebrae slide or bend when you move your neck more than they are supposed to, then you have a significant problem that is some cases has to be stabilized through surgical fusion.  I know that sounds extreme, but in the spine you can't reattach ligaments and stabilize the spine, the anatomy just will not allow it, so you end up with one option... fusion surgery.  

If you are in a car wreck, there are a few things that you need to have done:

1. Get your spinal ligaments checked through a stress x-ray study.  (You have to stress the ligaments to see if they are torn, this is about the only way unless you have access to an upright MRI.
2. Measurement  of spinal stability with CRMA is a must.  You can learn more on my website here, We are one of the only clinics in Western North Carolina using research based and validated software to check for spinal instabilities after MVCs.  Not even the hospitals in my area do this analysis, and it is straight from spinal biomechanics research and used in the AMA Guidelines to Impairment 5th and 6th editions.  If you haven;t had this done, it is a huge hole in your work-up because spinal ligament tears are the most common injury.
3. If you are having radiating pain into the arms or neck pain that is getting worse you may need to have electrodiagnostic studies (EMG.NCV) and/or an MRI.

Whatever you do, make sure that your condition is not minimized by ER or you primary care physicians.  These doctors are not spinal injury specialists, just as I am not an ER physician.  Get your spinal ligaments checked if you are in a car wreck.  If you have questions and are looking for a provider to help you, let me know, I may be able to help you find someone.
Dr. Shook is a spinal ligament injury specialist practicing in Hickory, NC.  His office is Hickory Spine, and he can be reached at (828) 324-0800.